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Glitazone (P5)

S Jill Stocks, Evangelos Kontopantelis, Artur Akbarov, Sarah Rodgers, Anthony J Avery, Darren M Aschroft

Type
Drug
ID
PH686
Version ID
1372
Data Sources
Valid event data range
Start - 01/02/2013
Sex
Female, Male
Agreement Date
2015-11-03
Coding system
GPRD product codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Study question:

What is the prevalence of different types of potentially hazardous prescribing in general practice in the United Kingdom, and what is the variation between practices?

Methods:

A cross sectional study included all adult patients potentially at risk of a prescribing or monitoring error defined by a combination of diagnoses and prescriptions in 526 general practices contributing to the Clinical Practice Research Datalink (CPRD) up to 1 April 2013. Primary outcomes were the prevalence of potentially hazardous prescriptions of anticoagulants, anti-platelets, NSAIDs, β blockers, glitazones, metformin, digoxin, antipsychotics, combined hormonal contraceptives, and oestrogens and monitoring by blood test less frequently than recommended for patients with repeated prescriptions of angiotensin converting enzyme inhibitors and loop diuretics, amiodarone, methotrexate, lithium, or warfarin.

Study answer and limitations:

49 927 of 949 552 patients at risk triggered at least one prescribing indicator (5.26%, 95% confidence interval 5.21% to 5.30%) and 21 501 of 182 721 (11.8%, 11.6% to 11.9%) triggered at least one monitoring indicator. The prevalence of different types of potentially hazardous prescribing ranged from almost zero to 10.2%, and for inadequate monitoring ranged from 10.4% to 41.9%. Older patients and those prescribed multiple repeat medications had significantly higher risks of triggering a prescribing indicator whereas younger patients with fewer repeat prescriptions had significantly higher risk of triggering a monitoring indicator. There was high variation between practices for some indicators. Though prescribing safety indicators describe prescribing patterns that can increase the risk of harm to the patient and should generally be avoided, there will always be exceptions where the indicator is clinically justified. Furthermore there is the possibility that some information is not captured by CPRD for some practices—for example, INR results in patients receiving warfarin.

What this study adds:

The high prevalence for certain indicators emphasises existing prescribing risks and the need for their appropriate consideration within primary care, particularly for older patients and those taking multiple medications. The high variation between practices indicates potential for improvement through targeted practice level intervention.

Publications

  • S Jill Stocks, Evangelos Kontopantelis, Artur Akbarov, Sarah Rodgers, Anthony J Avery, Darren M Ashcroft, Examining variations in prescribing safety in UK general practice cross sectional study using the Clinical Practice Research Datalink. BMJ, 351(h5501), 2015.

Clinical Code List

Rows: 31
Code Description Coding System (CPRD_product_code) Entity type Category
10051 Pioglitazone 45mg tablets CPRD_product_code res25: P5_glitazone drug
11601 Rosiglitazone 2mg / Metformin 500mg tablets CPRD_product_code res25: P5_glitazone drug
11604 Rosiglitazone 1mg / Metformin 500mg tablets CPRD_product_code res25: P5_glitazone drug
11609 Metformin with rosiglitazone 500mg + 1mg Tablet CPRD_product_code res25: P5_glitazone drug
11610 Metformin with rosiglitazone 500mg + 2mg Tablet CPRD_product_code res25: P5_glitazone drug
11717 Rosiglitazone 2mg / Metformin 1g tablets CPRD_product_code res25: P5_glitazone drug
11737 Metformin with rosiglitazone 1000mg + 4mg Tablet CPRD_product_code res25: P5_glitazone drug
11760 Metformin with rosiglitazone 1000mg + 2mg Tablet CPRD_product_code res25: P5_glitazone drug
14164 Avandamet 2mg/1000mg tablets (GlaxoSmithKline UK Ltd) CPRD_product_code res25: P5_glitazone drug
15232 Avandia 8mg tablets (GlaxoSmithKline UK Ltd) CPRD_product_code res25: P5_glitazone drug
17580 Avandamet 1mg/500mg tablets (GlaxoSmithKline UK Ltd) CPRD_product_code res25: P5_glitazone drug
18220 Pioglitazone 15mg / Metformin 850mg tablets CPRD_product_code res25: P5_glitazone drug
19472 Actos 45mg tablets (Takeda UK Ltd) CPRD_product_code res25: P5_glitazone drug
20287 Actos 15mg tablets (Takeda UK Ltd) CPRD_product_code res25: P5_glitazone drug
20889 Actos 30mg tablets (Takeda UK Ltd) CPRD_product_code res25: P5_glitazone drug
30316 Metformin with pioglitazone 850mg + 15mg Tablet CPRD_product_code res25: P5_glitazone drug
31077 Competact 15mg/850mg tablets (Takeda UK Ltd) CPRD_product_code res25: P5_glitazone drug
37617 Rosiglitazone 2mg tablet CPRD_product_code res25: P5_glitazone drug
469 Rosiglitazone 4mg tablets CPRD_product_code res25: P5_glitazone drug
48120 Avandia 2mg Tablet (GlaxoSmithKline UK Ltd) CPRD_product_code res25: P5_glitazone drug
48139 Pioglitazone 30mg tablets (A A H Pharmaceuticals Ltd) CPRD_product_code res25: P5_glitazone drug
5227 Rosiglitazone 8mg tablets CPRD_product_code res25: P5_glitazone drug
548 Pioglitazone 15mg tablets CPRD_product_code res25: P5_glitazone drug
56208 Pioglitazone 15mg tablets (A A H Pharmaceuticals Ltd) CPRD_product_code res25: P5_glitazone drug
56376 Rosiglitazone 4mg with glimepiride 4mg tablet CPRD_product_code res25: P5_glitazone drug
57659 Pioglitazone 30mg tablets (Actavis UK Ltd) CPRD_product_code res25: P5_glitazone drug
6855 Avandamet 2mg/500mg tablets (GlaxoSmithKline UK Ltd) CPRD_product_code res25: P5_glitazone drug
7325 Avandamet 4mg/1000mg tablets (GlaxoSmithKline UK Ltd) CPRD_product_code res25: P5_glitazone drug
7375 Rosiglitazone 4mg / Metformin 1g tablets CPRD_product_code res25: P5_glitazone drug
9662 Avandia 4mg tablets (GlaxoSmithKline UK Ltd) CPRD_product_code res25: P5_glitazone drug
9699 Pioglitazone 30mg tablets CPRD_product_code res25: P5_glitazone drug

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH686/version/1372/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH686/version/1372/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH686', '1372', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH686/version/1372/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH686/version/1372/export/codes/?format=json
CSV site_root/phenotypes/PH686/version/1372/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH686', '1372', api_client=client)

Version History

Version
ID
Name Owner Publish date
1372 Glitazone (P5) ieuan.scanlon 2021-10-06 currently shown

Export - export all codes into a csv file/JSON/XML for the current phenotype version.

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